Women will live a third of their lives in menopause. The complications of prolonged estrogen deficiency during the menopausal years are well established. Although hormone replacement therapy (HRT) can spare women some of these complications, the Women's Health Initiative findings indicate significant potential health risks, risks that prompt more and more women to turn from prescribed HRT to over-the-counter products in the hope that soy phytoestrogens and other "estrogens" from natural sources can replace prescription estrogens in terms of benefits while sparing critical side effects. In spite of the fairly widespread and now rapidly growing use o f phyto estrogens, maj or gap s remain in our knowledge o f their long-term efficacy and safety. We propose to conduct a "Soy Phytoestrogens As Replacement Estrogen (SPARE)" study in young menopausal women to evaluate the effectiveness of a 2-year treatment with purified soy isoflavones in preventing bone loss. Our study will also explore the effectiveness of oral isoflavones in preventing menopausal symptoms and other changes associated with estrogen deficiency. The study will characterize the actions of a defined preparation of soy isoflavones in humans and will correlate these actions with the circulating serum levels of the principal isoflavone metabolites, providing new insights on their long- term biological actions. This 5-year study will provide a foundation of knowledge from which menopausal women can begin to make more informed decisions regarding HRT and menopausal signs and symptoms.